Our future health system – My feedback to the PSA on the Health & Disability Reform

When the Government announced its response to the Health and Disability System Review in April 2021, the PSA invited members to provide feedback to a Working Group made up of delegates from the DHB and Community Public Services sectors. An email address has been set up exclusively to gather these member responses.

To further guide feedback, a health reform presentation [PSA, 2021] was produced in June containing three specific consultation questions for discussion. Below is a response to these questions.

1. Suppose you could develop a charter for the NZ health workforce, what values should be included to create what type of culture for workers?

A charter for the New Zealand health workforce has been proposed by Health Minister Andrew Little. In his announcement of the Government’s response to the Health and Disability System Review, he said: “A key element in creating a new culture will be a new New Zealand Health Charter, designed with health and care workers, to set down the values and principles of the national system” [Minister of Health, 2021]

Development of this charter, however, does not occur in a vacuum. Health and care workers may make our own culture, but we do not make it under self-selected circumstances; rather under circumstances existing already, given and transmitted from the past. It is worthwhile to briefly and critically review the historical context. 

A clear signal about salient circumstances transmitted from the past has been given in the Minister’s choice of language. Both the title and the description of this proposed document clearly reference the previous New Zealand Health Charter [Department of Health, 1989]. This earlier, short-lived charter contained five principles to guide the development and operation of the New Zealand health service. 

  • Respect for individual dignity
  • Equity of access 
  • Community involvement 
  • Disease prevention and health promotion
  • Effective resource use 

Viewed critically, it possible to discern how prevailing historical ideologies of the time may have shaped the selection of these values and principles and to what extent they might not be fit for purpose today. The description of “Effective resource use”, for example, as “extracting more health for more New Zealanders from every dollar of health expenditure” is a clear statement of neoliberal values (or in the more descriptive Australian terminology of the time, “economic rationalism”). 

Equally, “Respect for individual dignity” elevates Margaret Thatcher’s mythical “sovereign individual”. Even “Equity” is described as “a dimension of individual dignity”. In addition, it is framed as equal “access” (or opportunity), rather than equal health outcomes, reflecting the shift from post-War social democracy towards a Blairite social liberalism which was starting to take place in Aotearoa at the time. 

Viewed from the vantage point of 2021, it also striking that the principles in the 1989 New Zealand Health Charter make no reference to Māori values or Te Tiriti o Waitangi. Indeed, the word “Māori” never even appears. And yet this charter, launched by Health Minister Helen Clark, does contain some useful starting points. 

Having considered the purpose and background, here are five possible values and culture statements which could be included in a charter for the NZ health workforce (note that proposed translations have not been subject to consultation with mandated Tangata Whenua representatives, either within or or outside of the PSA, and represent my thoughts as Tangata Tiriti only):

  • People-centred/He Tangata, He Tangata, He Tangata: A shift from designing health systems around diseases and institutions towards health services designed around, and for people means that service users and communities should become active partners in improving health service delivery. 
  • Egalitarian/Mana Taurite: When the contribution of each person in the health workforce is valued without regard to social stratification, it fosters a health and disability system response attuned to each person’s health need. 
  • Democratic/Manapori: “Work culture is positive, trusting and effective through strong industrial democracy mechanisms that give workers strong collective voice through their union” [PSA, In publication].
  • Equitable/Taurite Ora: “In Aotearoa New Zealand, people have differences in health that are not only avoidable but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes” [Ministry of Health, 2019].
  • Respectful/Mana Tangata: A just culture allows people to report and learn from mistakes. Shifting from a culture of blame to a mana-enhancing culture of respect and trust has the potential to deliver significant benefits for the health system in terms of saved lives, harm prevented and resources freed up for the delivery of more and better care. [Ministry of Health, 2001a; E Tū, 2017]
  • Bicultural/Tikanga Rua: Colonisation, failure to honour te Tiriti o Waitangi and institutional racism have established and maintained relative disadvantage for Māori within the wider determinants of health, and within the health system. Overcoming monocultural perspectives is necessary to end victim-blaming and deficit thinking about Māori and other groups under-served by the system, improve system performance and support Equity [Health Quality & Safety Commission, 2019].

2. How can we make sure that community health services are better valued, understood and integrated into the health system?

“Community health services” (also known as “Tier 1” services) span a myriad of different structures and functions, from Primary Health Care to Disability Support, Aged Residential Care to Community Pharmacies, Dentists, Māori and Pacific providers and Laboratories. The task of better valuing, understanding and integrating them is extremely complex and involves daunting challenges, for which there are no easy answers.

The case for valuing, understanding and integrating them has been clear since at least as far back as the 1989 New Zealand Health Charter, which highlighted the need for “Community involvement” in order to direct greater attention to “Disease prevention and health promotion”. It is also very clear in the final report of the Health and Disability System Review [2020]

The recommendations in that final report for driving integration all have merit. It speaks, for example, of creating more interoperability of digital systems across hospitals and community health services. It recommends planning on a locality basis, from a population health perspective, and so on. 

A New Zealand Health Charter as suggested above, which values People-centredness/He Tangata, He Tangata, He Tangata, could also make a difference. But there are barriers to system integration, like the circumstances shaping workplace culture, which are given and transmitted from the past. And these are significant. 

The Health and Disability System Review [2020] recommends the creation of a NZ Health Plan which looks ahead 20 years, as a mechanism for valuing, understanding and integrating community health services. This too is a worthy goal.

But similar long-term strategies for Tier 1 have been created before. The Primary Health Care Strategy [Ministry of Health, 2001b], which established Primary Health Organisations two decades ago, was also intended to drive integration and planning on a locality basis, from a population health perspective. This was followed by “alliancing”, with the same goal. And yet it remains the case, as the Health and Disability System Review [2020] reported, that “the system is characterised by limited national planning, so that decisions which could be made once for the whole population are repeated multiple times.” Why has so little progress been made? 

The fundamental problem, which dates back to the creation of the modern public health system by First Labour Government in 1938, is clearly articulated in the case of Primary Health Care by Crampton [2005], Matheson [2017] and Gauld et al. [2019]. “The elephants in the room”, they write, are that “GPs, after all, are largely private business people” and “Ownership confers governance responsibility (ultimate control) for an organisation, and accountability for its actions.” The Ministry of Health, as system steward, can plan for integration of community health services and universal coverage. But ultimately, it is up to private businesses to decide how, when and where Primary Health Care is delivered, and at at what cost to patients. 

Gauld’s conclusion is applicable not only for Primary Health Care, but for many other community health services: “Further research is needed into the business ownership model, including whether this is fit for purpose for the future in meeting the increasingly complex health needs of diverse communities.” This issue has not been addressed at all by the current Labour Government. 

Neither has the contracting model, based on the “funder-provider split”. This was introduced to the health system in the 1990s, as part of radical neoliberal reforms aimed at creating a competitive health care market and fully commercialised health and hospital services, as precursor to privatisation of the public health system. A sustained wave of popular protest and low-level industrial action by unionised health workers managed to overturn some of the most unpopular reforms, such charging patients in public hospitals, but the funder-provider split remained intact [Hamed, 2013].

Under this neoliberal model, accountability for service delivery was to be delivered to departmental CEOs through contractual obligations (rather than, say, through tiers of democratically elected, Bicultural/Tikanga Rua governance, from the health service provider on upwards). These contracts, which now rule the provision of community health services, typically run for periods of one to three years and are regularly put up for tender.

The model is institutionally racist and inimical to Equitable/Taurite Ora values, producing shorter contracts and a heavier compliance burden for Māori health providers [Came et al., 2018]. The fixed term contracts drive short term thinking, prevent strategic system planning and integration and undermine the “predictability of funding” for Tier 1 which was called for in the Health and Disability System Review [2020]. Retaining this neoliberal model will almost inevitably defeat the proposed 20-year NZ Health Plan, as well.

For all the talk, in Health and Disability System Review [2020] and Department of Prime Minister and Cabinet [2021], about the need for need new structures “which ensure government is both closer to communities, and more nationally connected”, the fundamental structures of “embedded neoliberalism” in the health system [Kelsey, 2015; Bertram, 2020] have not been touched. 

Given that the Labour Government appears to have no appetite for dismantling neoliberalism, options for civil society actors such as unions, community groups and health service providers are limited. Nonetheless, they do exist.

One such option for the PSA to make sure that community health services are better valued, understood and integrated into the health system is to pursue bold industrial strategies. MECA coverage across both directly-employed Health NZ staff and those in the Community Public Services Sector, for instance, would reduce the incentives for outsourcing (disaggregation), foster a culture of “one team” and drive integration. Fair Pay Agreements setting common pay and conditions across the myriad of community health service providers would greatly reduce the incentive for competitive tendering for contracts, which tends to undermine integration. 

Ultimately, however, ensuring that community health services are fully valued, understood and integrated into the health system will require the political will to grasp the nettle of private ownership and control, under a very different social and economic system. 

3. How do we make sure that workers’ voice will guide the future health system?

The health system should be guided by the voice of all workers, in a way which recognises their different contributions. Broadly speaking, the types of worker voice can be categorised as clinical and non-clinical. The differences in contributions between these two groups are related to differences in training, along with professional obligations and legal requirements.

The benefits of clinician guidance in a health system are well established. In the New Zealand context, they have been confirmed by the Ministerial Task Group on Clinical Leadership [2009]. The New Zealand Nurses Organisation Tōpūtanga Tapuhi Kaitiaki o Aotearoa [2019] comments that, “Nurses can add real value to strategic decision-making in health care governance through their in-depth knowledge and experience of the human aspects and logistics of service delivery”. The Association of Salaried Medical Specialists Toi Mata Hauora [2015] concludes: “A health system led by clinicians is better for patient care and safety, and makes better use of available resources.” 

Two components of this clinical worker voice have been defined. Both are necessary for the future health system: “Clinical governance refers to the system where clinical goals are set and reported on. Clinical leadership is the operational system that allows health workers to do what is needed based on these goals” [ASMS, 2015].

Despite the widely recognised benefits of clinician leadership and the promotion of the idea by Health Ministers for the last 20 years, little progress has been made [ASMS, 2019]. Over this time however the barriers to progress have been clearly identified and well documented. If we are to ensure that the clinical workers’ voice guides the future health system, then these barriers must be overcome:

  • Lack of time, coupled with chronic workforce shortages. It’s very difficult to make room in the diary for clinical leadership activities when there aren’t enough clinicians for the clinical work required.
  • Professional capture. Clinical governance and leadership must be genuinely interprofessional and multidisciplinary, rather than a synonym for “doctors making the decisions”. 
  • Insufficient opportunities for training and mentoring. Leadership and governance by clinicians requires investment and a willingness to delegate and collaborate. 
  • Outdated management attitudes, shared by incumbent leaders of health systems who have risen within the hierarchy based on command and control methods. 

Management attitudes reflecting hierarchical, as opposed to Egalitarian/Mana Taurite values suppress worker voice among clinicians and non-clinicians alike. These attitudes are sustained, in turn, by other factors. Attention is turning increasingly towards one in particular. 

Since the start of 2020, organisations in the UK with more than 250 employees have been legally required to disclose the “pay ratio” between the salary of their CEO and their lowest paid employee. One of the reasons for this new requirement is that, “High CEO-employee pay ratios… send a message to company employees that a main purpose of the company is to serve individual self-interest. As social science studies reveal, this focus on self-interest gives rise to unethical cultures within companies” [Dallas, 2017]

There is a negative correlation between worker voice and CEO pay: “CEO pay is clearly lower in countries with greater worker voice in corporate decision-making” [Baker et al., 2019]. Capping CEO pay ratios in the health system therefore will have a material effect on strengthening worker voice. 

One further mechanism for ensuring worker voice in health system guidance is co-determination – the practice where workers employed by an organisation have the right to vote for representatives on its governance board. 

New Zealand lags behind in this practice. Board-level employee representation in the public or private sector is already required by law or custom in a majority of OECD countries, and in 19 out of 28 EU member states [Williamson, 2016]. Concerns which have been raised by unions and employers as to how worker representation at board level could work in the UK – for example, over co-option, confidentiality or skill deficits – have been addressed by the Trades Union Congress [Williamson, 2013].

Other parts of the wider New Zealand Public Service already have staff representatives on their governance boards. Under Section 171B of the Education Act 1989, for instance, every tertiary education institution must have at least one elected member of the teaching and/or general staff on their Council. Section 119 of the Education and Training Act 2020 requires that the Board of a State school must include a staff representative. 

The Government has shown its willingness to make bold changes to the health system – in particular in its decision to create a Māori Health Authority, with full commissioning powers. To make sure that workers’ voice guides the future health system in a way which reflects Democratic/Manapori values, they should require elected clinical and non-clinical staff representatives on the boards of publicly funded health providers. Given that almost 80 percent of the healthcare and social assistance workforce is female [Stats NZ, 2018], elected worker representation will also tend to create co-benefits for gender equity, alongside what must be respect for Bicultural/Tikanga Rua values and te tino rangatiratanga of Māori health workers. 

Finally, existing legal protections for health worker voice must be respected and extended. These include the obligation in Section 6(1) of the Public Health and Disability Act 2000 for DHBs (and by extension, Health NZ and other parts of the future health system) to “be a good employer”. And it definitely includes the right for health workers to comment publicly and engage in public debate on matters within their expertise and experience (enshrined in Schedule 1B of the Employment Relations Act 2000 and elaborated in collective agreements for many occupational groups). 


ASMS. [2015]. Making distributive clinical leadership work. https://www.asms.org.nz/wp-content/uploads/2015/07/ASMS-Advice-Making-Distributive-Clinical-LeadershipWork_163930.pdf 

ASMS. [2019]. ASMS Research Brief – Collective leadership: harnessing the knowledge and skills of clinicians to transform health care. https://www.asms.org.nz/wp-content/uploads/2019/08/Research-Brief-Distributed-clinical-leadership_172592.2.pdf

Baker, D. Bivens, J. & Schieder, J. [2019]. Reining in CEO compensation and curbing the rise of inequality. https://www.epi.org/publication/reining-in-ceo-compensation-and-curbing-the-rise-of-inequality/

Bertram, G. [2020]. The Future of New Zealand’s State Sector. https://www.newsroom.co.nz/ideasroom/the-future-of-the-new-zealand-state-sector

Came, H., Doole, C., McKenna, B. & McCreanor, T. [2018]. ‘Institutional racism in public health contracting: Findings of a nationwide survey from New Zealand’. Social Science & Medicine, 199, 132-139 https://doi.org/10.1016/j.socscimed.2017.06.002

Crampton, P. [2005]. ‘The ownership elephant: ownership and community – governance in primary care’. NZ Medical Journal, 118(1122), 68-78 https://citeseerx.ist.psu.edu/viewdoc/download?doi=

Dallas, L. [2017]. Behavioral Implications of the CEO-Employee Pay Ratio. https://corpgov.law.harvard.edu/2017/04/19/behavioral-implications-of-the-ceo-employee-pay-ratio/

Department of Health. [1989]. The New Zealand Health Charter. https://www.moh.govt.nz/notebook/nbbooks.nsf/0/1DF75C37B5FDC9AB4C2565D700186C3F/$file/Health%20Charter.pdf

Department of Prime Minister and Cabinet. [2021]. Our health and disability system – Building a stronger health and disability system that delivers for all New Zealanders. https://dpmc.govt.nz/sites/default/files/2021-04/heallth-reform-white-paper-summary-apr21.pdf

E Tū. [2017]. Building a Just Culture in the Workplace. https://etu.nz/wp-content/uploads/2017/07/Building-a-just-culture.pdf

Gauld, R., Atmore, C., Baxter, J., Crapmton, P & Stokes, T. [2019]. ‘The ‘elephants in the room’ for New Zealand’s health system in its 80th anniversary year: general practice charges and ownership models’. NZ Medical Journal, 132(1489), 8-14. https://assets-global.website-files.com/5e332a62c703f653182faf47/5e332a62c703f676dd2fc63f_Gauld%20FINAL.pdf

Hamed, O. [2013]. A social movement history of public opposition to New Zealand‟s health reforms, 1988-1999. https://www.scribd.com/document/131575075/Health-and-Hospitals-PHD-Thesis-Draft

Health and Disability System Review. [2020]. Health and Disability System Review – Final Report – Pūrongo Whakamutunga. https://systemreview.health.govt.nz/assets/Uploads/hdsr/health-disability-system-review-final-report.pdf

HQSC. [2019]. He Matapihi Ki Te Kounga O Ngā Manaakitanga Ā-Hauora O Aotearoa 2019 – A Window On The Quality Of Aotearoa New Zealand’s Health Care 2019. https://www.hqsc.govt.nz/assets/Health-Quality-Evaluation/PR/Window_2019_web_final.pdf

Kelsey, J. [2015]. The FIRE Economy – New Zealand’s Reckoning. Wellington: Bridget Williams Books

Matheson, D. [2017]. The Kurow Cure – Worth Another Crack. https://ucannz.wordpress.com/tag/the-kurow-cure/

Minister of Health. [2021]. Building a New Zealand Health Service that works for all New Zealandershttps://www.beehive.govt.nz/speech/building-new-zealand-health-service-works-all-new-zealanders

Ministerial Task Group on Clinical Governance. [2009]. In Good Hands – Transforming Clinical Governance in New Zealand. https://www.aemh.org/images/AEMH_documents/2018/15_In-Good-Hands-Report.pdf

Ministry of Health. [2001a]. Reportable Events Guidelines. https://www.health.govt.nz/system/files/documents/publications/reportableevents.pdf

Ministry of Health. [2001b]. The Primary Health Care Strategy. https://www.health.govt.nz/publication/primary-health-care-strategy

Ministry of Health. [2019]. Achieving Equity. https://www.health.govt.nz/about-ministry/what-we-do/work-programme-2019-20/achieving-equity

NZNO. [2019]. Growing Nurses Into Governance – A Governance Toolkit. https://www.nzno.org.nz/LinkClick.aspx?fileticket=BMuMA18DWM8%3D

PSA. [2021]. The Health and Disability Reform. https://drive.google.com/file/d/13snmexSVgR21xFXsmZQoriiHmbaxzbj4/view?fbclid=IwAR1TXgmbyJJ35EfBhXh5HJkZgQcoZ-YRIvJeCe8_uY51Ox5cz9kXSliF9wU

PSA. [In publication]. Our strategic goals – the outcomes we want to achieve 2021 – 2027.

Stats NZ. [2018]. Employment highest ever for women. https://www.stats.govt.nz/news/employment-highest-ever-for-women

Williamson, J. [2013] Workers on Board: The case for workers’ voice in corporate governance. London: Trades Union Congress. https://www.tuc.org.uk/sites/default/files/Workers_on_board.pdf

Williamson, J. [2016]. All Aboard – Making Worker Representation on Company Boards a Reality. https://www.tuc.org.uk/sites/default/files/All_Aboard_2016_0.pdf

Reflections on the LHP Symposium: ‘From Kinleith to the dole queue: workers’ struggles of the 1980s’

Reflections on the 2021 Labour History Project Symposium by Paul Maunder and Grant Brookes.

Paul Maunder, LHP Bulletin Editor, reflects

The seminar left me with the feeling of having experienced a contradiction at a deep level, but one which is not easy to articulate.

Having started off on a high (the victory at Kinleith), the union movement, as a social and political institution, obviously diminished in power and influence during the 1980s. From the Federation of Labour having a high media profile and with ready access to government, the body became something of a marginal player. And this diminishing has never been reversed.

Of course this is explicable. During the decade the manufacturing sector virtually disappeared, and this sector had provided the labour intense work sites that were often the base of militant unionism. But as well, white collar jobs were re-organised with short term contracts and an approaching digitalising of work. Meanwhile the service sector grew, characterised by low wages and precarious conditions. There was probably only hard-fought-for continuity in health and education, both sectors proving resistant to neoliberalism.

This was the negative story of the day.

The positive story was the diversification of the union movement during this same period, opening itself to women, other gender, Maori and Pasifika voices, leading to campaigns for equal pay, against sexual harassment and racial discrimination and beginning to bring tiriti relations into the movement.

The contradiction is that the garden in which this flowering took place diminished in size, even though the impulse was shared with more human rights focused campaigns. And there have been some notable blooms: the important care workers campaign and of course the more recent living wage campaign.

Yet, at the end of the day, at the negotiating table, a worker is a worker and a manager a manager, no matter what gender, race or sexuality either might be. The culture of the organisation getting the case together and the negotiating process should be inclusive, but that is not ultimately the matter up for negotiation, nor can failure be excused by good intentions.

Put it this way: If the negotiating team is ethnically, gender and sexually diverse, yet doesn’t achieve a good result, there is a cultural achievement yet ultimately a union failure. Scale this up to workers not getting their share of the cake and growing inequity, the end of union monopoly and the reduction of collective bargaining, poor health and safety, the housing crisis, an inadequate benefit system… The latter can be downplayed and the former celebrated – and there is cause for celebration − but also a failure if it becomes the goal of the union movement, that is, if the culture of the union movement becomes the central focus of the movement, as a way to sidestep the dominant crisis.

And was it in the eighties that this possible confusion of intent, imposed by crisis, became present?

In writing this I become aware of being on dangerous ground, but perhaps I am old enough and irrelevant enough as a Marxist to test the thinning ice of post modernism.

Grant Brookes, PSA Eco Network National Co-Convenor and nurse, reflects

History, as they say, is written by the victors. And in Aotearoa in the 1980s, there is no doubt who the victors were. 

So complete was their control of the narrative that up until February’s Symposium even my own memory, as a young adult during that decade, contained recollections of dole queues but none of the strike at Kinleith. 

As a consequence of this, the newly restored ‘Kinleith ’80’ film, shown at the start of the day, was an eye-opener. For me it was riveting to see the power of working people when we organise and the way that industrial struggle can transform every area of our lives, from our gendered relationships to cultural attitudes. The people in the film looked and sounded like my uncles and aunts. It brought the history to life. 

From that high point, as a number of speakers observed soberly, the trajectory for our class was downhill. 

But not everything was lost. As I entered the workforce myself in the following decade, the gains from Fighting sexual harassment in the 1980s had been sustained – at least in my unionised, public sector workplaces. Those oral histories from the Clerical Workers Union in the early eighties were eye-opening, in a different way. They were shocking. 

A highlight of the day for me was the presentation on Workers’ resistance to destructuring in the 1980s. This challenged the prevailing state-centred account of the rise of neoliberalism, which sees it as a response to the failure of Keynesian policy prescriptions and an organised takeover by ideologues in Treasury and in the Fourth Labour Government. 

The alternative explanation offered, in terms of a class assault to address a crisis of capitalist profitability, seems to me to allow an answer to the question posed in the final Panel on Intergenerational conversations: “Does history provide the answers for how to address our current crises?”

That answer is – yes it does, when theorised correctly. Many of the systemic drivers are the same today. Viewed through the right lens, history provides us with track markers and signposts the pitfalls. Although they do not know it, multitudes of working people in this country owe a debt of gratitude to LHP for keeping the flame of scholarship alight and organising symposiums such as this, where answers might be found for us all. •

First published in LHP Bulletin, 81, 52-3. Re-posted with permission. For a one year individual membership of the Labour History Project and subscription to the Bulletin, deposit $30 to the LHP Kiwibank account, 38 9012 0672630 00, and email malatestacampbell@gmail.com with notification of deposit.

‘Questions for the NZNO Board and CEO’ – Unpublished letter to Kai Tiaki

As top public sector union leaders went in to bat for their members and for public services over the last fortnight, one group was conspicuously missing in action. With DHB nurses facing the prospect of a four year pay freeze and voting for historic strike action, where were the NZNO President, Kaiwhakahaere and Chief Executive?

NZNO member-leaders and DHB sector reps have spoken up for us brilliantly in the media. But from the three top positions – which collectively cost members around half a million dollars a year – there’s been silence. It wasn’t like that last time, under my watch.

NZNO President, Kaiwhakahaere and CEO front a press conference to announce that union members had voted to reject the DHB offer, 18 June 2018.

But asking hard questions like this, and seeking accountability for fee-paying members, may no longer be allowed in the letters page of Kai Tiaki Nursing New Zealand

Founded in 1908, a year before NZNO, Kai Tiaki has enjoyed editorial independence for 113 years. Although under increasing strain in recent years, this freedom from control by vested interests and independence from political agendas of the day has enabled Kai Tiaki to remain the pre-eminent voice of nursing in Aotearoa New Zealand. The professional journalists employed at Kai Tiaki have set the editorial policies, including for example a “Letters to Editor Policy” which upholds freedom of expression and opposes censorship, so that the letters pages can remain an important forum for debate. “Kai Tiaki Nursing New Zealand is committed to publishing all letters it receives”, it says.

But no longer. On 14 May, the day that the DHB strike was announced, the acting CEO of NZNO sent an email. It wasn’t about supporting the strike. A decision on printing my letter to the May issue of Kai Tiaki, asking questions of the NZNO Board, had been taken out of the co-editors’ hands. I had been banned. The letters to policy and the CEO’s email are reproduced here side-by-side.

Two questions arise immediately. Why is the acting NZNO CEO interfering in editorial decisions at Kai Tiaki and undermining the operations of our prized journal? And does the NZNO Board approve of this censorship? 

It appears that an NZNO member can now be barred permanently from the letters page of our journal. My unpublished letter is posted below, so readers can judge for themselves whether there is any validity at all in Mairi Lucas’ justifications. 

The NZNO Board has approved a Strategic Plan which stresses that NZNO is a democratic, membership-driven organisation. But this is not how a democratic, membership-driven organisation operates. The Board should direct the acting CEO to respect Kai Tiaki’s editorial independence. Let the different sides of a story be told, and let those same old false and divisive allegations, which are now trotted out routinely in response to any criticism of the leadership, stand the test of scrutiny and debate.

As stated in my original letter below, NZNO members deserve a functional system of governance that meets their legitimate needs and expectations – at the very least including public support, when they’re going on strike. Heaven knows we pay enough for it. 

Letter to Kai Tiaki, 27 April 2021 

Questions for the NZNO board of directors continue to grow. 

The board’s chief executive (CE) employment committee hoped to appoint a new NZNO CE before Memo Musa’s last day, said board member Simon Auty in the February issue of Kai Tiaki Nursing New Zealand (p7). There had been “a significant number” of applications, he added. 

Applications closed on 26 January. Musa finished on 26 February. It is now May. Why has no CE been appointed? 

What does it mean for NZNO democracy, now that the full-time leadership team consists of a single individual in a permanent role with two in acting positions who previously worked under her? (Eg. see here, and here)

How can the President fulfil her constitutional role as the representative of non-Māori members, in NZNO’s bicultural partnership, if she’s also part of Te Poari meetings of the Māori leadership? 

What has happened to the full independent review of the NZNO Constitution which members voted for last year? According to the Terms of Reference sent to all members in December, it’s supposed to be completed in time for the 2021 NZNO AGM, four months from now. Yet there’s no sign that it’s even started. 

In March, Kai Tiaki Nursing New Zealand reported that a “board review recommends some radical changes” (p4). Key recommendations of the review included a smaller board of nine, an appointed chair, two appointed directors to bridge skill gaps, a half-time president and kaiwhakahaere and a strategic wānanga “to clarify how the bicultural model enhanced NZNO’s purpose and vision”.

If the board won’t release the report to members, as they should, will they at least inform us of their response to the recommendations

And when will NZNO have a functional system of governance that meets the legitimate needs and expectations of the fee-paying members? 

Grant Brookes, RN

PSA Mental Health delegates support NZNO members

The letter of support for the NZNO members of the DHB Sector below was sent to their Industrial Advisor David Wait on 4 May 2021, for the attention of the members and their bargaining team.

Tēnā koutou David me ngā mema o tō koutou uniana,

We write to you as a group of PSA union delegates at Capital & Coast DHB. Please feel free to share this letter.

We are your colleagues, who work alongside you in the DHB Sector. We know from personal experience the difference nurses make to the lives of health consumers, tāngata whaiora and to our communities.

We see your unsafe workloads, under-staffing and stress. We’re affected by it too.

So when the “April Fool’s Day” offer was released, we shared your dismay. In a very real sense, our fortunes are entwined with yours.

When DHB spokesperson Dale Oliff tried to justify it as “reasonable in the context of other public and health sector settlements”, we were angry not only because it showed how little the DHBs thought of you, but because she was obviously talking about our pending offers as well.

As you now undertake a strike ballot and nationwide members’ meetings, we cannot sit silently on the sidelines.

We applaud your decision to reject the DHB offer. We encourage you to push hard for a settlement that reflects your value. As you push, know that we are with you. If push comes to shove we pledge you our support.

Nō reira, kia kaha, kia maia, kia manawanui! Be strong, be brave, be stout hearted!

Nā mātou noa, nā

PSA Delegates Committee
Mental Health, Addictions & Intellectual Disability Service

PSA Eco Network: Your new convenors, Wellington vacancy, PSA Strategic Goals, submissions and protests!

It has been two months since our last newsletter for Eco Network members. The Network Convenors would like to provide an update on how the Network has been promoting environmental interests within the PSA, facilitating the sharing of information and resources and encouraging engagement and action on the environment.


Thank you for your Climate Change submission feedback

We would like to thank members who provided feedback for the PSA submission to the Climate Change Commission on its draft advice to Government on climate action in Aotearoa. Some clear themes came through:

  • Considering emissions from the production of imported products which are consumed in New Zealand, not just those emitted by local production
  • Enabling Local Government to make effective decisions for climate change mitigation and adaptation, including aligning the Local Government Act and the Building Act and Code 
  • There should be no buying of emissions units from overseas to balance New Zealand’s carbon budget
  • Achieving an equitable transition means strengthening workplace democracy.

The feedback also addressed the need for the PSA to become more sustainable, too.

The final PSA submission can be viewed on the PSA website here. According to the Commission, ours was one of more than 15,500 submissions which they are now reviewing. Thank you to everyone who submitted – whether individually, through your work or through contributions to collective submissions like the PSA’s.

Making climate justice a PSA strategic goal

Since our last newsletter, the Eco Network Convenors have also participated in the refresh of the PSA Strategic Goals 2018-2024. The outcome of this three-yearly review will set the guideposts for how the PSA advances the interests of members.

The Eco Network is clear that there are no jobs, no unions and no people on a dead planet.

After seeking input from members, Eco Network Convenors met with PSA President Benedict Ferguson and provided a written submission to the Executive Board. We have called for the addition of a new Strategic Goal for the PSA: Climate Justice. Our submission argued that only a standalone goal can give the appropriate level of visibility and mana to this existential issue.

At the same time, we said that the existing Goals should also be updated to address climate change. This is necessary to clarify and build the narrative of the intersections between climate and workers’ justice. You can find our submission online here

School Strike 4 Climate

On 9 April 2021, thousands of students and supporters took to the streets in cities and towns around Aotearoa for the latest School Strike 4 Climate. PSA members and staff attended events around the country. 

The school strikers this year delivered six demands for the Government to take real, meaningful climate action. These had a strong focus on union issues like the impacts of climate change on working people and the need to invest in a just transition. They also echoed many of the points in the PSA’s submission to the Climate Change Commission and the approach to public transport in the PSA’s “Let’s Do Even Better” campaign.

SS4C was supported by the PSA . After a shout out to the Eco Network to help, Network members signed up as volunteers on the day, arranged the loan of megaphones and mobilised support from within the PSA and in the wider union movement 

Climate Change Minister James Shaw tweeted his support and told students in Wellington they needed to keep on showing up and putting the pressure on the politicians right across the House. 

Young people are showing us the way. The Eco Network Convenors look forward to many more opportunities for the Network to engage in environmental activism for the benefit of union members. 

Introducing your new convenors

We are very pleased to introduce three new Eco Network Convenors:

  • Grant Brookes – National Co-Convenor 
    Grant has been involved in the Eco Network for a while as the Wellington Convenor. Grant has now stepped up to the National Co-Convenor role alongside Briar Wyatt. Grant works as a Mental Health Nurse at CCDHB in Wellington. 
  • Alana Reid – South Island Regional Convenor 
    Alana Reid works at Dunedin City Council on building consents. She is a member of the PSA Executive Board and Local Government Sector Committee, and now also a representative for South Island PSA Eco Network members. 
  • Shonagh Clark – Auckland Regional Convenor 
    Shonagh Clark works in the contact centre at Statistics NZ in Auckland. She is a representative for Auckland Eco Network members.

Wellington convenor vacancy

As Grant is now Eco Network Co-Convenor, this has created a Wellington Convenor vacancy.

We welcome expressions of interest for this role.

Network convenors help to develop and coordinate plans, activities, Eco Reps and members in their region and across the country. We also have unelected Eco Rep roles that anyone can volunteer for to participate as a leader in the network. More details about the roles, associated responsibilities and election process can be found on our website here under the ‘Eco Network Structure’ tab.

We invite you to express your interest in the Wellington convenor role or to be an Eco Rep. You can do so by emailing eco@psa.org.nz with a paragraph or two about yourself and why you are interested in the role.Please get in touch by Friday 14 May with your expression of interest.

Please share these opportunities with other PSA members. If anyone is not an Eco Network member they can join by updating their details on the PSA website here or by emailing eco@psa.org.nz 

Ngā mihi, 
Grant Brookes and Briar Wyatt 
PSA Eco Network National Co-Convenors